Cyclosporiasis

Description

Cyclospora cayetanensis, previously known as cyanobacterium-like, coccidia-like, and cyclospora-like bodies (CLB), is a protozoan parasite that causes gastrointestinal infection.

Occurrence

Infection can be acquired worldwide by persons of all ages. Outbreaks in North America have been linked to various types of imported fresh produce. Infection is acquired by ingestion of water or food contaminated with the parasite. Usually the symptoms of infection begin about 1 week later.

Risk for Travelers

Travelers to low-income countries can be at increased risk for this infection, and the risk can vary with the season. Which season is of greatest risk varies by country. For example, in Nepal, risk of infection is greater in the summer and rainy season.

Clinical Presentation

Infection can be asymptomatic or manifested by such symptoms as watery diarrhea, loss of appetite, weight loss, bloating, increased gas, stomach cramps, nausea, vomiting, fatigue, muscle aches, and low-grade fever. Some travelers first notice influenzalike symptoms. If untreated, the illness can last for weeks to months, and the symptoms can come and go.

Prevention

No vaccine is available. Travelers to resource-poor countries should be advised to follow the precautions in Risks From Food and Drink. Direct, person-to-person transmission is unlikely because the parasite is not immediately infectious when excreted.

Treatment

The treatment of choice is trimethoprim-sulfamethoxazole. Travelers may also be advised to consult with an infectious disease specialist. Physicians may consult CDC about patients who are allergic to or intolerant of sulfa-containing medications. For more information, see the Division of Parasitic Diseases website at http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/factsht_cyclospora.htm and http://www.cdc.gov/ncidod/dpd/parasites/cyclospora/healthcare_cyclospora.htm.

— Barbara Herwaldt